Individual
DR. ROBERT L BRUCKSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
290 CENTRAL AVE, SUITE 206, LAWRENCE, NY 11559-8507
(516) 239-2332
(516) 371-2251
Mailing address
290 CENTRAL AVE, SUITE 206, LAWRENCE, NY 11559-8507
(516) 239-2332
(516) 371-2251
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
117212-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00216904
—
NY
Enumeration date
07/31/2005
Last updated
11/10/2011
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